Objective To evaluate the efficacy and safety of intraoperative pleural irrigation with Nocardia rubra cell-wall skeleton (N-CWS) for reducing pleural effusion drainage after radical surgery for lung cancer. Methods A retrospective analysis was conducted on the clinical data of lung cancer patients who underwent lobectomy and mediastinal lymph node dissection at the First Affiliated Hospital of Xiamen University between December 2024 and May 2025. Patients were divided into a control group and an irrigation group based on the intraoperative use of N-CWS. Patients in the irrigation group received pleural irrigation with 800 μg of N-CWS diluted in 10 mL of normal saline. The following outcomes were compared between the two groups: pleural effusion drainage volume at 0-24 h, 24-48 h, and 48-72 h postoperatively, degree of air leak, chest tube duration, postoperative length of stay, and the incidence of adverse events (fever, chest pain, and nausea and vomiting). Results A total of 245 patients were included (97 males, 148 females) with a mean age of (61.28±6.26) years, with 205 in the control group and 40 in the irrigation group. Compared to the control group, the irrigation group showed significantly lower pleural effusion drainage volumes at 0-24 h, 24-48 h, and 48-72 h, as well as shorter chest tube duration and postoperative length of stay (all P<0.05). There was no statistical difference in the degree of postoperative air leak (P=0.661). No significant differences were observed between the two groups regarding the highest body temperature within 72 h post-surgery (P=0.130), fever grade (P=0.196), severity of chest pain (P=0.105), or the incidence of nausea and vomiting (P=0.376). Conclusion Intraoperative pleural irrigation with N-CWS in patients undergoing lobectomy and mediastinal lymph node dissection for lung cancer can significantly reduce postoperative pleural effusion drainage volume, shorten chest tube duration and length of hospital stay. The procedure is safe and feasible.

Background/Aims: Biliary tract cancer (BTC) frequently harbors KRAS mutations, which are associated with resistance to traditional treatment and a poor prognosis. Synthetic lethality (SL) strategy may provide other targets of KRAS. Therefore, we aim to identify and validate potential therapeutic targets of KRAS for the treatment of BTC via SL. Methods: The dependency (DepMap) projects were used to predict the synthetic lethal gene of KRAS. FDA-approved anticancer drug library was applied to screen potential drugs effective against KRAS-mutant BTC. Furthermore, the synthetic lethal effects or corresponding mechanisms of potential genes and drugs on BTC were investigated using KRAS-mutant and KRAS-wild type BTC cell lines, patient-derived xenografts (PDX), and KRAS oncogene-driven tumor models, as well as other KRAS-mutant cancer cell lines. Results: Initially, we discovered that the loss of GATA2 reduced the viability of KRAS-mutant but not KRAS-wild-type BTC. Subsequently, the drug library screened out disulfiram, which primarily exerts a synthetic lethal effect by inhibiting interleukin-1β (IL-1β) in KRAS-mutant BTC. Mechanistically, GATA2 specifically enhanced the transcription of IL-1β to promote NF-κB signaling in KRAS-mutant BTC. IL-1β inhibition phenocopied GATA2 deficiency, leading to reduced KRAS-mutant BTC viability. These synthetically lethal effects were confirmed using PDX, a KRAS oncogene-driven tumor model, as well as in other KRAS-mutant cancer cell lines. Conclusions In summary, these results indicate that inhibiting GATA2/IL1β could be a therapeutic strategy in KRAS-mutant BTC and potentially other cancers.

Objective To analyze the epidemiological characteristics of newly diagnosed occupational coal workers' pneumoconiosis (CWP) in Gansu Province. Methods All newly diagnosed cases of CWP reported online in Gansu Province from 2005 to 2024 were collected as study subjects through the "Occupational Diseases and Health Hazard Factors Monitoring Information System". A descriptive epidemiological method was used to analyze the epidemiological characteristics. A total of 886 newly diagnosed CWP cases were reported in Gansu Province during 2005-2024. Results Among them, cases initially diagnosed as stageⅠ, stage Ⅱ, and stage Ⅲ accounted for 68.8%, 20.0%, and 11.2%, respectively. The cases were predominantly male, accounting for 99.0%. Age groups of 50-<60 years and ≥60 years accounted for 47.0% and 42.9%, respectively. In terms of regional distribution, Lanzhou City, Pingliang City, and Baiyin City were the main affected areas, accounting for 36.0%, 19.1%, and 16.4%, respectively. Regarding industry distribution, the coal mining and washing industry accounted for 91.3% of the cases. Enterprises of large and small sizes accounted for 46.0% and 29.7%, respectively. In terms of enterprise economic types, state-owned enterprises and private enterprises accounted for 54.2% and 21.6%, respectively. The median duration of dust exposure among newly diagnosed CWP cases was 18 years. As of 2024, 102 cases had progressed to a more advanced stage; among the progressed cases, stageⅠ, stage Ⅱ, and stage Ⅲ cases accounted for 58.1%, 28.3%, and 13.6%, respectively. Conclusion Cases of CWP in Gansu Province are mainly distributed in large state-owned coal mines in cities such as Lanzhou, Pingliang, and Baiyin, predominantly affecting older males with longer dust exposure durations. Therefore, occupational health supervision and management in coal dust-related enterprises in the province should be further strengthened, and the occupational health examination procedures for workers exposed to dust should be standardized.

ObjectiveTo investigate whether Carthamus tinctorius L.-derived nanovesicles （CDNVs） can alleviate angiotensin Ⅱ （ANGⅡ）-induced cardiomyocyte （H9C2） hypertrophy by inhibiting the NF-κB signaling pathway and to elucidate the underlying molecular mechanisms. MethodsCDNVs were isolated and purified by ultracentrifugation combined with sucrose density gradient centrifugation， and their morphology and particle size distribution were identified by transmission electron microscopy and nanoparticle tracking analysis. Rat H9C2 cardiomyocytes were cultured in vitro and randomly divided into the normal control group （NC）， ANGⅡ （1.0 μmol/L） group， ANGⅡ+CDNVs group， and ANGⅡ+CDNVs+NF-κB activator 1 group. After 24 h of intervention， cell viability was detected by the CCK-8 assay， the expression of myocardial hypertrophy-related genes （ANP， BNP） was determined by qPCR， the relative cell area was measured by phalloidin staining， the expression of hypertrophy marker proteins and NF-κB pathway proteins （P-p65/p65， P-IκBα/IκBα） was examined by Western blot， and nuclear translocation of p65 was observed by immunofluorescence. Subsequently， NF-κB signaling pathway agonist activator 1 was added， and the expression of myocardial hypertrophy marker proteins and NF-κB pathway proteins was detected. ResultsCDNVs exhibited a typical round-like vesicle structure with an average particle size of 140.4 nm， which was consistent with the morphological characteristics of exosomes. ANGⅡ at concentrations of 0.1-1.0 μmol/L had no significant effect on cardiomyocyte viability. Compared with the NC group， ANGⅡ significantly upregulated the gene expression of ANP and BNP， increased the relative surface area of cardiomyocytes， elevated the levels of myocardial hypertrophy marker proteins and NF‑κB pathway proteins， and promoted the nuclear translocation of p65 （P<0.05）. Following treatment with CDNVs， all the above indicators were markedly reduced in comparison with the ANGⅡ group （all P<0.05）. However， all these experimental results were reversed after the addition of an NF‑κB agonist. ConclusionCDNVs alleviate ANGⅡ-induced H9C2 cell hypertrophy by inhibiting the NF-κB signaling pathway.

Objective Jejunal interposition is an important option for restoring gastrointestinal continuity in patients with complex esophageal cancer in whom the stomach is unavailable for reconstruction due to previous gastrectomy, tumor involvement, failed gastric conduit, or other constraints. Although the jejunum offers a caliber similar to the esophagus, a rich blood supply, and preserved peristaltic function, anatomical variations in mesenteric length and vascular arcades render long-segment and high-level reconstruction susceptible to excessive tension, mesenteric torsion, venous congestion, and inadequate distal perfusion. This consensus aims to provide standardized recommendations for the application of jejunal interposition in this specific patient population. Methods This consensus was developed in accordance with the WHO Handbook for Guideline Development and Chinese national guideline development standards, with reference to the Appraisal of Guidelines for Research & Evaluation Ⅱ(AGREE Ⅱ), Reporting Items for Practice Guidelines in Healthcare (RIGHT), and Scientific, Transparent and Applicable Rankings (STAR) checklists. The project was registered on the international practice guidelines registry platform (PREPARE-2026CN1384). The working group systematically searched Chinese and English evidence addressing 12 clinical questions. Evidence was graded using the Oxford Centre for Evidence-Based Medicine (OCEBM) 2009 system, with structured appraisal of risk of bias, inconsistency, indirectness, and imprecision. Recommendations were formulated through two rounds of Delphi surveys and a face-to-face consensus meeting, with an agreement threshold of ≥75%. Results The consensus generated 12 recommendations covering indications, selection between jejunum and colon, preoperative assessment, surgical approach and reconstruction route, pedicled jejunal interposition (PJI), supercharged pedicled jejunal interposition (SPJ), indocyanine green (ICG) perfusion assessment, perioperative nutrition, management of anastomotic leakage, long-term follow-up, and special treatment scenarios. Given that the available direct evidence is predominantly derived from single-center retrospective cohorts and case series, recommendations extrapolated from general esophagectomy or other gastrointestinal surgical evidence are deliberately phrased with caution. Conclusion Jejunal interposition is a safe and effective approach for digestive tract reconstruction in patients with complex esophageal cancer in whom the stomach is unavailable. This consensus emphasizes that clinical decision-making should be individualized based on the patient's prior treatment history, reconstruction height, vascular anatomy, technical availability, and institutional experience in the Chinese context.

OBJECTIVE To explore the relationship between peripheral blood interferon γ(IFN-γ)/interleukin-4(IL-4)and the short-term prognosis of children with Mycoplasma pneumoniae pneumonia(MPP),and to analyze the influencing factors for the short-term prognosis of children with MPP.METHODS A total of 170 children with MPP admitted to the hospital from Jan.2021 to Jan.2024 were selected(MPP group).Based on the condition 28 days after treatment,they were divided into a poor prognosis group(n=49)and a good prognosis group(n=121).Clinical data of the children were collected,and the levels of peripheral blood interleukin-4(IL-4)and inter-feron-γ(IFN-γ)were measured to calculate the IFN-γ/IL-4 ratio.Multivariate Logistic regression model was used to analyze the factors affecting the short-term prognosis of children with MPP.RESULTS In the poor prognosis group,the duration of antibiotic use,the proportion of pleural effusion,the proportion of extrapulmonary compli-cations,and the levels of peripheral blood IL-4 and IFN-γ were higher than those in the good prognosis group,while the IFN-γ/IL-4 ratio was lower than that in the good prognosis group(P＜0.05).Logistic regression re-sults showed that persistent fever,prolonged antibiotic use and the occurrence of extrapulmonary complications were risk factors for the short-term prognosis of children with MPP(P＜0.05),and a high IFN-γ/IL-4 ratio was a protective factor(P＜0.05).CONCLUSION Persistent fever,prolonged antibiotic use and extrapulmonary com-plications are risk factors for the short-term prognosis of children with MPP,and high IFN-γ/IL-4 values is a pro-tective factor.

Objective:To investigate the effectiveness of the Rain Classroom teaching model in the Functional Experiment Science.Methods:A total of 61 clinical medicine students from grade 2021 at a medical college were enrolled and divided into the control group(n=30)who received traditional experimental teaching,and the experimental group(n=31)who was taught using the Rain Classroom teaching model.Ultimately,the outcomes compared between the two groups included scores of experimental assignments,satisfaction with the teaching model,and the experimental group's supporting rate for the Rain Classroom teaching mode.Results:The experimental score in the experimental group was significantly higher than that in the control group(P＜0.05).Additionally,58.06%(18/31)of the experimental group supported the Rain Classroom model.Among the experimental group,77.42%(24/31)and 70.97%(22/31)of the students believed that the Rain Classroom teaching mode could enhance the awareness of autonomous learning and the mastery of key and difficult knowledge.Conclusion:Through the Rain Classroom teaching mode,students'experimental grades have been improved,and it also plays a certain role in promoting the enhancement of their self-study ability.

Objective:To analyze the risk factors of anxiety and depression in prostate cancer patients after castration, and establish a risk prediction model.Methods:A retrospective analysis was conducted on the data of 60 prostate cancer patients treated in Xi′an People′s Hospital from January 2019 to January 2022. The patients were divided into a training group ( n=42) and a validation group ( n=18) at a ratio of 7∶3. The patients received surgical castration and medical castration. One month after castration, the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were used to evaluate the anxiety symptoms and depression levels of the patients, respectively. Univariate and multivariate logistic regression analyses were used to identify the risk factors for negative emotions in prostate cancer patients after castration, and a risk prediction model was established. Results:In the training group, 19 patients had a SAS score ≥50, and 21 patients had an SDS score ≥50. Based on these scores, the training group was divided into a negative emotion group ( n=19) and an emotional stability group ( n=23). Multivariate logistic regression analysis showed that marital status, castration scheme, and postoperative Visual Analogue Scale (VAS) score were independent influencing factors for negative emotions in prostate cancer patients after castration ( OR=3.589, 3.364, 5.912, all P<0.05). In both the training group and the validation group, the risk scores of patients with negative emotions were significantly higher than those with emotional stability. In the training group, the area under the curve (AUC) of the risk prediction model for predicting negative emotions was 0.747, with a specificity of 71.02% and a sensitivity of 66.11%; in the validation group, the AUC, specificity, and sensitivity were 0.761, 66.59%, and 76.21%, respectively. The Hosmer-Lemeshow test showed that χ 2 was 4.285 6, P value was 0.830, and the c-index was 0.773(0.692-0.854). The calibration curve showed that the predicted curve was basically consistent with the actual curve, indicating that the prediction model had good discriminative ability and accuracy. Decision curve analysis showed that the model had high clinical significance. Conclusions:Marital status, castration scheme, and postoperative VAS score are important factors affecting anxiety and depression in prostate cancer patients after castration, and the regression model can successfully predict the risk of negative emotions.

Objective:To evaluate the efficacy and feasibility of a domestically developed robotic surgical system based on fiber-optic dedicated line communication in cross-regional urological telesurgery.Methods:This was multicenter，single-arm，retrospective case series study. The data of patients who underwent urological telesurgeries using the telesurgical system between January 2023 and December 2024 were analyzed. The cohort included 59 patients from seven hospitals across China. Among the patients，47 were male（79.7%）and 12 were female（20.3%），with a median age of 63.0（56.0，68.0）years and a body mass index of（24.7 ± 3.0）kg/m 2. Surgical procedures included 32 radical prostatectomies，24 partial nephrectomies，one radical nephrectomy，one adrenalectomy，and one ureteral reconstruction. The perioperative indicators，pathological results and postoperative complications were analyzed. The network monitoring data were collected，and the perioperative data of patients，remote system monitoring data and costs were compared between the two communication modes of optical transport network（OTN）and cloud-connect network（CCN）. Results:All 59 remote surgeries were successfully completed，with a mean operative time of（138.0 ± 54.0）minutes，median intraoperative blood loss of 50.0（30.0，100.0）ml and a postoperative hospital stay of 5.0（4.0，6.0）days. No cases required reoperation，Clavien-Dindo grade ≥3 complications，or readmission. The geographical distance between the primary and remote surgical sites ranged from 450 to 2 800 km. Network monitoring revealed increased bidirectional latency with distance increasing：the shortest latency time（Hefei-Hangzhou，450 km）was（16.59 ± 0.80）ms，while the longest（Harbin-Hangzhou，2 200 km）latency time was（53.31 ± 0.31）ms. Average frame loss per procedure was 0?1.27 frames. The results of subgroup analysis comparing OTN and CCN communication modes showed no significant differences in operative time［（130.7 ± 70.5）minutes vs.（142.1 ± 42.9）minutes， P = 0.442］，postoperative hospitalization［6.0（4.0，8.0）d vs. 5.0（4.0，6.0）d， P = 0.581］，or readmission rates（0 vs. 0）. However，CCN demonstrated significant cost advantages with 500 RMB per operation vs. 3 000 RMB per operation for OTN. Conclusions:Urological telesurgery using fiber-optic communication is feasible. The CCN mode，with its cost-effectiveness，excellent usability，and multi-point interconnection flexibility，is currently the preferred communication model for telesurgical applications.

Objective:To establish a new method and platform for screening, identifying, and exploring a new strategy for anti-hepatitis B immunotherapy based on hepatitis B virus (HBV)-specific TCR.Methods:Peripheral blood mononuclear cells were isolated from patients with acute hepatitis B. CD3 +CD8 +CD137 +T single cells were sorted out after stimulation with the HBsAg peptide library. The α and β chains in TCRs of single cells were amplified by PCR. TCR double-chain pairing and lentiviral packaging were performed through high-throughput sequencing. Re-infected Jurkat-76-NFAT-GFP cells and the cell lines stably expressing TCR were screened. HBsAg peptide library and immortalized B lymphocytes co-cultured with J76N-TCR were used to screen HBsAg-specific TCRs. K562 cell lines stably expressing HLA-A*24:02 were established to determine epitope peptide by screening A*24:02-restricted TCR. The screened TCRs were replaced with mouse C regions and packaged with lentiviruses. Functional validation was performed on healthy human CD4 +T and CD8 +T lymphocytes following infection. Results:Stable TCR-expressing cell lines were successfully prepared based on single-cell TCRαβ double-chain amplification and pairing technology. Twenty-one TCRs were screened using immortalized B lymphocytes, resulting in nine possible HLA-A*24:02-restricted HBsAg-specific TCRs. Further screening with K562-A2402 resulted in six A*24:02-restricted HBsAg-specific TCRs with identically recognized epitope peptide. The functional determination of the two TCR clones revealed their specific recognition function for target cells expressing HBsAg.Conclusion:HLA-A*24:02-restricted HBsAg-specific TCR with recognition function for target cells expressing HBsAg was successfully obtained based on the new experimental technology system, laying an important foundation for further exploration of antiviral immunotherapy based on HBV-specific TCR.